Mycoplasma pneumoniae pneumonia in children

Mycoplasma pneumoniae(M.pneumoniae)is a common pathogen that causes community-acquired pneumonia in children.The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractory cases.Complications may occur,such as necrotizing pneumonia and respiratory failure.Extrapulmonary complications,including encephalitis,myocarditis,nephritis,hepatitis,or even multiple organ failure,can also arise.In this editorial,we dis-cuss the clinical implications of the significant findings from the article"Serum inflammatory markers in children with M.pneumoniae pneumonia and their predictive value for mycoplasma severity"published by Wang et al.They reported that measuring lactic dehydrogenase,interleukin-6 levels,and D-dimer effectively predicts refractory M.pneumoniae pneumonia cases.

Analysis of the Role of D-Dimer,Interleukin-6,and Interleukin-18 in Differential Diagnosis of Pediatric Refractory Mycoplasma pneumoniae Pneumonia

Objective:To analyze the value of D-dimer(D-D),interleukin-6(IL-6),and IL-18 in the differential diagnosis of children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods:The medical records of 92 children with Mycoplasma pneumoniae pneumonia(MPP)treated in the hospital were selected for retrospective analysis from January 2023 to January 2024.After comprehensive examinations such as computed tomography examination of the chest,48 children with general Mycoplasma pneumoniae pneumonia(GMPP)were put in the GMPP group and 44 children with RMPP were grouped in the RMPP group.The IL-6,IL-18,and D-D levels were compared between the two groups,and the receiver operating characteristic(ROC)curves were plotted to analyze their value for differential diagnosis of RMPP.Results:The levels of IL-6,IL-18,and D-D in the RMPP group were higher than those in the GMPP group(P<0.05);the ROC curves showed that the specificity of the differential diagnosis of IL-6,IL-18,and D-D was higher,and their diagnostic value was significant.Conclusion:Determination of IL-6,IL-18,and D-D levels in children with MPP can further diagnose the children’s condition,which can help physicians formulate targeted treatment plans,and is of great significance to the improvement of the children’s condition,which is worthy of attention.

Serum inflammatory markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for mycoplasma severity

BACKGROUND Mycoplasma pneumoniae pneumonia(MPP)significantly impacts pediatric health,necessitating markers for early severe disease identification.AIM To investigate the correlation between serum inflammatory marker and the severity of MPP in children.METHODS A prospective study was carried out from January 2023 to November 2023.A total of 160 children with MPP who underwent treatment were selected:80 had severe MPP and 80 had mild MPP.Clinical and laboratory data were collected at the time of hospital admission and during hospitalization.Receiver operating characteristic curves were utilized to assess the diagnostic and prognostic for severe MPP.RESULTS Fever duration and length of hospitalization in pediatric patients with severe MPP exceeded those with mild MPP.The incidence of pleural effusion,lung consolidation,and bronchopneumonia on imaging was markedly elevated in the severe MPP cohort compared to the mild MPP cohort.In contrast to the mild cohort,there was a notable increase in C-reactive protein(CRP),procalcitonin(PCT),erythrocyte sedimentation rate,lactic dehydrogenase,D-dimer,and inflammatory cytokines[interleukin(IL)-6,IL-8,IL-10 and tumor necrosis factor(TNF)-α]in the severe MPP group were significantly higher.CONCLUSION Serum inflammatory markers(CRP,PCT,IL-6,D-dimer,IL-10 and TNF-α)were considered as predictors in children with severe MPP.

Chinese herbal medicine combined with Western medicine for Mycoplasma pneumoniae pneumonia in children:An overview of systematic reviews

Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.

Understanding serum inflammatory markers in pediatric Mycoplasma pneumoniae pneumonia

This editorial reflects on the research,which investigates the potential of serum markers to predict the severity of Mycoplasma pneumoniae infections.Mycoplasma pneumoniae pneumonia(MPP)is a prevalent cause of respiratory infections in children,often leading to significant morbidity.Predicting the severity of MPP can significantly enhance patient management and outcomes.This editorial reviews the role of specific laboratory markers:(1)Lactate dehydrogenase;(2)Interleukin(IL)-6;(3)IL-10;(4)Tumor necrosis factor-α;and(5)D-dimer in predicting the severity of MPP in pediatric patients.Elevated levels of these markers are strongly associated with severe cases of MPP,providing clinicians with valuable tools for early diagnosis and targeted intervention.

Research Progress on Combined Chinese and Western Medicine Treatment of Mycoplasma pneumoniae Pneumonia in Children

With the continuous development of medical technology,combined treatment of Chinese and Western medicine has gradually become a research hotspot.As a common disease in pediatrics,the treatment of Mycoplasma pneumoniae pneumonia(MPP)in children is also being explored and improved.This article summarizes the research progress of combined Chinese and Western medicine treatment of MPP in children in recent years,aiming to provide a useful reference for the combined treatment of MPP in children.The article firstly introduces the etiology and pathogenesis of MPP in children,thereafter briefly introduces the Western anti-infective treatment and traditional Chinese medicine(TCM)diagnosis and treatment of MPP in children,and lastly introduces the methods of combined treatment of TCM and Western medicine in detail.The article points out that the combination of Chinese and Western medicine can give full play to the overall regulation of Chinese medicine and the precise treatment advantages of Western medicine,improve the therapeutic effect,reduce the use of antibiotics,and lower the recurrence rate of the disease,which is worthy of further research and promotion.

Status of <i>Mycoplasma pneumoniae</i>Pneumonia in Chinese Children: A Systematic Review

Mycoplasma pneumoniae pneumonia (MPP) becomes one of the most important health problems in China recently. Date for MPP inChinais scarce. Although macrolides and/or cortical steroids had been reported to be effective treatment for MPP, the long-term outcome remained uncertain. A study on status of MPP in China was conducted via a systematic review of published studies which have the Chinese data and collected from published PubMed and core journals of China Knowledge Resource Integrated Database (CNKI). The analysis was based on epidemiology, clinical characteristics, treatment, drug resistance and prognosis. Twenty five articles concerned about MPP in Chinese children and adolescent were enrolled, including 11 studies on epidemiology/etiology, 11 studies on clinical characteristics, 7 studies on drug resistance, 5 studies on treatment from China's Mainland respectively. The overall incidence of MPP ranged from 7.1% to 54.4%. Fever and cough were most frequently identified in manifestations. Drug resistance to macrolides ranged from 18.9% to 90%. The outcome of treatment in patients who received combined treatment of macrolides, cephalosporin antibiotics and/or cortical steroid seems to be better than those who received macrolides only. Macrolide combined with cephalosporin or cortical steroid both may decrease the severity of MPP in the past decade. There was not enough evidence to suggest that cortical steroid can decrease the mortality of MPP in children. And a multi-center, randomized double blind research on the effect of cortical steroid was encouraged.

The Effect of Azithromycin in Treating Mycoplasma Pneumonia in Children

Objective:To discuss and analyze the effect of azithromycin in the treatment of mycoplasma pneumonia in children.Methods:A total of 120 children with mycoplasma pneumonia who were admitted to the Department of Pediatrics of our hospital from January 2022 to December 2022 were selected as the research subjects.They were divided into an azithromycin group and a reference group according to the random number drawing method,with 60 cases in each group.The azithromycin group was treated with azithromycin,and the reference group was treated with conventional treatment.The efficacy of treatment,laboratory indicators,platelet count and D-dimer,and adverse reactions of both groups were compared.Results:The efficacy of the azithromycin group was significantly higher than that of the reference group(P<0.05).Before treatment,there were no significant differences in the laboratory indicators like ferritin,procalcitonin(PCT),and erythrocyte sedimentation rate(ESR)between the two groups(P>0.05);after treatment,the laboratory indicators of the azithromycin group were significantly better than those of the reference group(P<0.05).Before treatment,there was no statistically significant difference in platelet count and D-dimer between the groups(P>0.05);after medication,the platelet count,and D-dimer in the azithromycin group were significantly better than those in the reference group(P<0.05).The total incidence of adverse reactions in the azithromycin group was significantly lower than that in the reference group(P<0.05).Conclusion:Azithromycin is more effective in treating mycoplasma pneumonia in children,and has certain clinical value.

Analysis of knowledge graph based on CiteSpace research on the treatment of pediatric pneumonia with traditional Chinese medicine

Objective:Based on the CiteSpace tool,this study makes a visualization analysis on the treatment of infantile pneumonia with traditional Chinese medicine in the past 20 years,so as to explore the development status,research hotspots and frontier trends of the treatment of infantile pneumonia with traditional Chinese medicine,and provide a reference for the research on the treatment of infantile pneumonia and related diseases with traditional Chinese medicine.Methods:A total of 645 literatures related to the treatment of pediatric pneumonia with traditional Chinese medicine were retrieved from CNKI.The visual atlas was made by year,author,institution and key words,and the co-occurrence,clustering and emergence analysis were performed.Results:The related literatures span from January 2001 to February 2021,and the number of related literatures showed an obvious increasing trend,with an average annual publication of 38 papers.From 2002 to 2014,the increase was the most obvious,and began to show a gentle growth trend in 2015.Twelve main clusters were obtained by keyword cluster analysis.Emergent analysis results in a total of 19 emergent words,which are composed of 439 nodes and 1,452 lines in total.There are different research hotspots in different periods,and in the past five years,the clinical efficacy of traditional Chinese medicine in the treatment of infantile pneumonia and the related research of traditional Chinese medicine characteristic nursing has become a contemporary hot spot.Conclusion:At present,the research on the treatment of children's pneumonia with traditional Chinese medicine shows an increasing trend.There is still a lack of continuity among various studies.The cooperation between the authors and various institutions is low.Moreover,the research direction in this field mainly focuses on children's mycoplasma pneumonia.In addition,the clinical efficacy observation of the combination of traditional Chinese medicine and azithromycin in the treatment of children's pneumonia will become a hot topic in the future.In addition to the research focus in this field,the clinical efficacy of TCM(traditional Chinese medicine)in the treatment of infantile pneumonia and the characteristic nursing of traditional Chinese medicine may still become one of the hot spots in the future.

Effects of methylprednisolone or immunoglobulin when added to standard treatment with intravenous azithromycin for refractory Mycoplasma pneumoniae pneumonia in children

Background:The prevalence of Mycoplasma pneumoniae pneumonia has increased considerably in recent years.To evaluate the efficacy of combined treatment of azithromycin with intravenous immunoglo-bulin (IVIG) or methylprednisolone in children with refractory Mycoplasma pneumoniae pneumonia (RMPP).Methods:Children with RMPP were randomly allocated to group A [intravenous azithromycin (IA)+ methylprednisolone],group B (IA+IVIG) or group C (IA alone).Following a 7-day treatment,group C patients were randomly separated into two sub-groups:group C1 (IA+methylprednisolone) and group C2 (IA+IVIG).Temperature,respiratory symptoms and signs were examined.The average febrile period after treatment (F2),average total febrile period (F3),infiltration absorption,atelectasis resolution,pleural effusion disappearance were determined.The levels of C-reactive protein (CRP),D-dimer,and lactate dehydrogenase (LDH) were measured.Results:Seven days after enrollment,the average F2 after treatment of group A was the shortest.Compared with the control group C,the combined treatment group A and B showed higher rates of infiltration absorption,atelectasis resolution and pleural effusion disappearance,while lower levels of serum CRP,D-dimer and LDH.Fourteen days after enrollment,all children with combined therapy clinically improved,and presented better laboratory results.Group C1 showed shorter F3 and lower levels of CRP and LDH than those of group C2.Overall,group A showed the shortest F3,also has the lowest CRP and LDH.Conclusions:Azithromycin with IVIG or methylprednisolone was better treatment for children with RMPP than azithromycin alone.IVIG treatment may be beneficial,especially when the efficacy of corticosteroids is insecure,thus could be considered as an alternative of primary therapeutic approaches.

Surveillance of Mycoplasma pneumoniae infection among children in Beijing from 2007 to 2012

Background Mycoplasma pneumonia （M.pneumoniae） is one of the key pathogens of community-acquired pneumonia.A global pandemic of M.pneumoniae has occurred since 2010.The aim of this study was to survey the prevalence of M.pneumoniae in children in Beijing from 2007-2012.Methods A total of 3 073 clinical specimens were obtained from pediatric patients with respiratory tract infections from January 2007 to December 2012,and examined by nested polymerase chain reaction.PCR products were visualized by 2％ agarose gel electrophoresis,positive products sequenced,and compared with reference sequences in GenBank.Macrolide resistance-associated mutations were also detected for some positive samples.Results Of the 3 073 specimens,588 （19.13％） were positive for M.pneumoniae,12.4％ of which were accompanied by viral infections.Positive rates for M.pneumoniae were highest in 2007 and 2012,showing a significant difference when compared with other years.Infections tended to occur in autumn and winter and positive rates were significantly higher for children aged 3-16.The rate of macrolide resistance-associated mutations was 90.7％,and the predominant mutation was an A→G transition （89.92％） at position 2063 in domain V of the 23S rRNA gene.Conclusions M.pneumoniae outbreaks occurred in 2007 and 2012 in pediatric patients in Beijing,which is consistent with the global prevalence of M.pneumoniae.M.pneumoniae can cause multi-system infections in children,and may be accompanied with viral infections.We determined that school-age children are more susceptible to this disease,particularly in autumn and winter.Gene mutations associated with macrolide resistance were very common in M.pneumoniae-positive specimens during this period in Beijing.

Necrotizing pneumonia caused by refractory Mycoplasma pneumonia pneumonia in children

Background To investigate the clinical features of necrotizing pneumonia (NP) caused by refractoryMycoplasma pneumo-niae pneumonia (RMPP). Methods A retrospective observational study was carried out in patients with NP caused by RMPP who were admitted to our hospital from January 2008 to December 2015, and the clinical manifestations, laboratory data, imaging performances, hospital courses and outcomes were analyzed. Results Twenty-five patients with NP caused by RMPP were collected, with a median age of 5.1 (4.0–7.9) years. The mean duration of fever and hospital stay was 21.0 ± 8.9 and 19.9 ± 9.9 days, respectively. The levels of lactate dehydrogenase (LDH), C-reactive protein, interleukin (IL)-6, IL-10 and interferon-gamma were elevated. Meanwhile, the pleural fluid cell count, LDH and protein were also increased. 80.0% of the patients had pleural effusion;and a high incidence of lobar atelectasis and pulmonary consolidation was found the patients. The mean duration from the onset of symptoms to the discovery of necrotic lesions was 21.0 ± 6.9 days. 80.0% of the patients were administrated corticosteroids, and bronchoalveolar lavage was extracted separately from all patients. Of the 20 patients who presented with pleural effusion, 11 underwent thoracocentesis alone and 2 underwent chest drainage. All patients received prolonged courses of antibiotics (32.2 ± 8.7 days). All patients were dischaged home and recovered without surgical intervention;and chest lesions were resolved or only minimal residual fibrotic changes were residual within 3.0 (2.0–6.0) months. Conclusions Necrotizing pneumonia caused by RMPP is severe, however, self-limiting and reversible. Good outcomes can be achieved with appropriate management.

Mycoplasma pneumoniae pneumonia in hospitalized children diagnosed at acute stage by paired sera

Background Mycoplasma pneumoniae （M. pneumoniae） is a frequent cause of respiratory tract infections. However,there is deficient knowledge about the clinical manifestations of M. pneumoniae infection. We described the clinical and laboratory findings of M. pneumoniae pneumonia in hospitalized children who were all diagnosed by a ≥ fourfold increase in antibody titer.Methods M. pneumoniae antibodies were routinely detected in children admitted with acute respiratory infection during a one-year period. The medical history was re-collected from children whose M. pneumoniae antibody titer increased≥fourfold at the bedside by a single person, and their frozen paired serum samples were measured again for the M.pneumoniae antibody titer.Results Of the 635 children whose sera were detected for the M. pneumoniae antibody, paired sera were obtained from 82 and 29.3% （24/82） showed a ≥ fourfold increase in antibody titer. There were 24 cases, nine boys and 15 girls, aged from two to 14 years, whose second serum samples were taken on day 9 at the earliest after symptom onset; the shortest interval was three days. All children presented with a high fever （≥38.5℃） and coughing. Twenty-one had no nasal obstruction or a runny nose, and five had mild headaches which all were associated with the high fever. The disease was comparatively severe if the peak temperature was ＞39.5℃. All were diagnosed as having pneumonia through chest X-rays. Four had bilateral or multilobar involvement and their peak temperatures were all ≤ 39.5℃. None of the children had difficulty in breathing and all showed no signs of wheezing.Conclusions The second serum sample could be taken on day 9 at the earliest after symptom onset meant that paired sera could be used for the clinical diagnosis of M. pneumoniae pneumonia in children at the acute stage. M. pneumoniae is a lower respiratory tract pathogen. Extrapulmonary complications were rare and minor in our study. High peak temperature （＞39.5℃） is correlated with the severity of M. pneumoniae pneumonia in children.

Effect of Qingfei Mixture (清肺合剂) on Pediatric Mycoplasma Pneumoniae Pneumonia with Phlegm Heat Obstructing Fei (Lung) Syndrome

Objective： To explore the effect and mechanism of Qingfei Mixture （清肺合剂）, a Chinese medicine, in treating mycoplasma pneumonia （MP） in MP patients and rat model. Methods： A total of 46 MP children with phlegm heat obstructing Fei （Lung） syndrome were randomly assigned to two groups by the method of random number table, with 23 children in each group. The control group was treated with intravenous infusion of azithromycin; the treatment group received intravenous infusion of azithromycin and oral administration of Qingfei Mixture. The treatment course was 7 days. Major symptoms and minor symptoms were observed and scored before and after treatments. A rat model of MP was also established. A total of 120 wistar rats were randomly divided into 5 groups： a normal group, infection group, Qingfei Mixture treatment group, azithromycin treatment group, and Qingfei Mixture ＋ azithromycin treatment group. Each group contained 24 rats, from which every 6 were euthanatized 1, 3, 7 and 14 days after infection. MP DNA in pulmonary tissue homogenates was detected using real-time fluorescence quantitative polymerase chain reaction. Pathology was assessed after hematoxylin （HE） staining and lung tissue pathology scores were determined in pulmonary tissue. Transmission electron microscopic detection and electronic image analysis were performed on lung tissue 3 days after infection. Intedeukin （IL）-17 was detected in serum using enzymelinked immunosorbent assay （ELISA） 7 days after infection. Results： In the clinical study, both control and the treatment group showed improved results on removing symptoms of phlegm heat syndrome compared to the control group （P〈0.05）. In animal experiments, On the 7th day after MP infection, as detected by electron microscopy, the pulmonary capillary basement membranes of the azithromycin ＋ Qingfei Mixture treatment group were much thinner than those of the azithromycin or Qingfei mixture treatment groups （P〈0.05）. The level of serum IL-17 in the azithromycin ＋ Qingfei Mixture treatment group was lower than that in the azithromycin or Qingfei Mixture groups （P〈0.01）. Conclusion： Both Qingfei Mixture and azithromycin have therapeutic effects on mycoplasma pneumoniae pneumonia, but the combination of both agents had the greatest effect.

Progression of anti-mycoplasma drug therapy in children with refractory mycoplasma pneumonia

The incidence of refractory mycoplasma pneumoniae pneumonia(RMPP)in children is increasing year by year,and the disease is progressing rapidly.It is accompanied by serious complications and legacy effects,seriously affecting the quality of life of children.The selection,dosage,and course of anti-MP drugs in children with RMPP have brought a lot of troubles to pediatric hospitals.In the present study,the characteristics,usage and dosage,drug resistance mechanism,and treatment progress of anti-MP drugs for the treatment of RMPP in children were reviewed.Collectively,our findings provided ideas for the treatment of children with RMPP using anti-MP drugs.

从“风痰瘀虚”辨析儿童难治性肺炎支原体肺炎细胞因子风暴

难治性肺炎支原体肺炎(RMPP)常由肺炎支原体肺炎进展而来,儿童发病率逐年升高,临床上迁延不愈容易并发多器官损伤。中医药辨治该病有一定优势,重归经典,与本病病理变化结合,提出细胞因子风暴是导致肺系重症症候群的主要原因,其特点与风温之邪致病相类,痰瘀为病进之主因,虚象显现于疾病始末。现以“风痰瘀虚”为总纲,阐述儿童RMPP细胞因子风暴之治则治法,当分三期:细胞因子风暴前驱期,宣泻结合以平温热;风暴爆发期,化瘀逐痰以通肺络;细胞因子风暴缓解期,健脾益肺以养气阴,当灵活遣用方药,并结合中医外治之法以进一步提升疗效。

Autotaxin对儿童难治性肺炎支原体肺炎的预测价值及其与炎性细胞因子的相关性

目的探讨血清和支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)自分泌运动因子(autotaxin)水平对儿童难治性肺炎支原体肺炎(refractory Mycoplasma pneumoniae pneumonia,RMPP)的预测价值及其与白细胞介素-6(interleukin-6,IL-6)、白细胞介素-8(interleukin-8,IL-8)及C-反应蛋白(C-reactive protein,CRP)的相关性。方法回顾性选取2019年1月至2021年12月收治的MPP患儿238例为研究对象,根据疾病严重程度分为RMPP组(82例)和普通肺炎支原体肺炎(general Mycoplasma pneumoniae pneumonia,GMPP)组(156例)。比较各组血清和BALF中autotaxin、IL-6、IL-8及CRP水平,分析血清和BALF中autotaxin水平对儿童RMPP的预测价值,以及RMPP患儿autotaxin水平与IL-6、IL-8及CRP水平的相关性。结果RMPP组血清和BALF中autotaxin、IL-6、IL-8及CRP水平均高于GMPP组(P<0.05)。RMPP患儿急性期血清和BALF中autotaxin、IL-6、IL-8及CRP水平均高于恢复期(P<0.05)。受试者工作特征曲线显示,血清和BALF中autotaxin水平对儿童RMPP均具有较好的预测价值(P<0.05),曲线下面积分别为0.874(95%CI:0.816~0.935)、0.862(95%CI:0.802~0.924)。相关分析显示,RMPP患儿血清和BALF中autotaxin水平与IL-6、IL-8及CRP水平均呈正相关(P<0.001)。结论RMPP患儿血清和BALF中autotaxin水平明显升高,且与病情恢复程度和炎性细胞因子相关,可作为儿童RMPP的预测指标。

肺炎支原体肺炎患儿急性期和恢复期血浆H-ficolin和L-ficolin水平分析

目的了解肺炎支原体肺炎患儿急性期和恢复期血浆中H-ficolin、L-ficolin水平的变化。方法采用ELISA法检测85例肺炎支原体肺炎患儿急性期和恢复期血浆H-ficolin、L-ficolin水平，并进行相关性分析。结果急性期H-ficolin水平18～252uq／ml，平均（119±59）ug／ml，恢复期H-ficolin水平0．3～26．5ug／ml，平均（10．1±57）ug／ml，急性期明显高于恢复期（Z=2．161．P=0.031）。急性期L-ticolin水平0．2～106μg／ml，平均（4．5±2.3）ug／ml，恢复期L-ficolin水平0．03～102μg／ml，平均（4．6±22）uq／ml，急性期和恢复期无统计学差异（t=0.245，P=0.807）。患儿急性期血浆H-ficoNn水平与L-ficolin水平明显相关（r=0.22，P=0.039）。结论H-ficolin可能参与儿童肺炎支原体肺炎疾病过程。

联合检测儿童难治性支原体肺炎肺泡灌洗液IL-8、IL-10及INF-γ的意义

目的:探讨联合检测儿童难治性支原体肺炎(RMPP)肺泡灌洗液(BALF)白细胞介素-8(IL-8)、白细胞介素-10(IL-10)及干扰素-γ(INF-γ)的意义。方法:回顾性分析2016年11月-2018年5月本院收治的RMPP患儿65例的临床资料为研究组,其中行支气管肺泡灌洗35例为A组,行支气管肺泡灌洗无效再接受激素治疗的30例患儿为B组。将同期行支气管肺泡灌洗的肺炎支原体肺炎患儿45例设为对照组。结果:研究组患儿BALF中细胞总数、上皮细胞及中性粒细胞比例均显著高于对照组(P<0.05),但淋巴细胞、嗜酸性粒细胞和巨噬细胞比例和对照组比较差异均无统计学意义(P>0.05);治疗前,研究组BALF中的IL-8、INF-γ水平均高于对照组,IL-10水平低于对照组(P<0.05);治疗后,B组患儿IL-8、INF-γ水平均高于A组,IL-10水平低于A组(P<0.05);研究组患儿BALF中的IL-8、INF-γ水平与疗效呈负相关,而IL-10水平与疗效呈正相关。结论:难治性支原体肺炎患儿BALF中的IL-8、IL-10及INF-γ会出现异常表达,各指标水平与患儿的疗效有密切关系,值得推广和应用。

E-selectin和sICAM-1在儿童肺炎支原体感染中的价值

目的探讨E-选择素(E-selectin)与可溶性细胞间黏附分子-1(s ICAM-1)在儿童肺炎支原体感染中的应用价值。方法选取本院儿科急性期肺炎支原体感染的患儿48例,恢复期患儿42例,选取同期体检的40例健康儿童做为对照组,采用ELISA法测定血浆E-selectin和s ICAM-1水平。用ROC曲线评价E-selectin和s ICAM-1对急性期肺炎支原体感染的诊断效能;将急性期患儿血浆E-selectin与s ICAM-1浓度进行相关性分析。结果急性期患儿血浆E-selectin和s ICAM-1的水平明显高于恢复期及健康对照组,差异有统计学意义(P<0.05);E-selectin诊断急性期肺炎支原体肺炎的AUC为0.852(95%可信区间为0.751-0.952),其敏感度为80.0%,特异度为78.5%;s ICAM-1诊断急性期肺炎支原体肺炎的AUC为0.859(95%可信区间为0.764-0.954),其敏感度为80.5%,特异度为80.0%。急性期患儿E-selectin和s ICAM-1水平呈明显正相关(r=0.758,P<0.01)。结论急性期肺炎支原体感染患者血浆E-selectin和s ICAM-1水平显著增高,可作为评价肺炎支原体感染病情程度以及治疗疗效观察的重要指标。